Oscillatory brain network changes after transcranial magnetic stimulation treatment in patients with major depressive disorder
Oscillatory brain network changes after transcranial magnetic stimulation treatment in patients with major depressive disorder
复制标题
重度抑郁症患者经颅磁刺激治疗后脑振荡网络的变化
DOI：
10.1016/j.jadr.2021.100277
复制
发表时间：
2021
影响因子：
--
通讯作者：
Yoji Hirano*
中科院分区：
文献类型：
--
作者：
Ryo Mitoma;Shunsuke Tamura;Hiroshi Tateishi;Takako Mitsudo;Ichiro Tanabe;Akira Monji;Yoji Hirano*
背景资料：重复经颅磁刺激（rTMS）治疗难治性抑郁症（MDD）因其有效性和低侵入性而受到关注。最近的神经影像学研究表明，rTMS在MDD中的作用可能是基于异常大脑网络的改善。然而，rTMS后的振荡网络变化仍不清楚。本研究的目的是检测振荡脑电图（EEG）标记，反映rTMS的治疗效果。方法：我们治疗了15个难治性MDD患者的高频（10 Hz）rTMS在左前额叶皮层6周。使用临床EEG数据，比较rTMS前后每个电极的功率谱密度和所有电极对之间的相位滞后指数。结果：rTMS治疗后抑郁症状明显改善。此外，功能之间的连接左额颞叶和枕叶区域在θ波段和伽马功率在前中央区增加后，在两个半球。增加功能连接在θ波段与改善认知功能，而增加γ功率与恶化的抑郁症状相关。限制：样本量相对较小。结论：我们的研究结果表明，振荡变化θ波段功能连接后，在MDD患者rTMS。这些发现，使用临床EEG方法获得的，提供了证据的基础神经生理学作用的rTMS对MDD的功能性脑网络变化的背景下，并可能构成一个生物标志物，用于评估MDD治疗。
Background: Repetitive transcranial magnetic stimulation (rTMS) has attracted attention for treating treatment-resistant major depressive disorder (MDD) because of its effectiveness and low invasiveness. Recent neuroimaging studies suggest that the effects of rTMS in MDD may be based on improvements in abnormal brain networks. However, oscillatory network changes after rTMS remain unclear. This study aimed to detect oscillatory electroencephalography (EEG) markers that reflect the therapeutic effects of rTMS.Methods: We treated 15 treatment-resistant MDD patients with high-frequency (10 Hz) rTMS over the left prefrontal cortex for 6 weeks. The power spectral density at each electrode and the phase lag index between all electrode pairs were compared before and after rTMS using clinical EEG data. The relationships between EEG indices, depressive symptoms, and cognitive function were also examined.Results: Depressive symptoms were significantly improved after rTMS. Additionally, functional connectivity between the left frontal–temporal and occipital regions in the theta band and gamma power in the anterior–central area were increased in both hemispheres after rTMS. Increased functional connectivity in the theta band was correlated with improved cognitive function, while increased gamma power was correlated with worsened depressive symptoms.Limitations: The sample size was relatively small.Conclusion: Our results demonstrated oscillatory changes in theta-band functional connectivity after rTMS in MDD patients. These findings, obtained using clinical EEG methods, provide evidence of the underlying neurophysiological effects of rTMS on MDD within the context of functional brain network changes, and may constitute a biomarker for evaluating MDD treatments.